一种使用三通道外管和多把钳子进行内镜下大肠黏膜切除术的新方法：实验评估
A novel approach to endoscopic colorectal mucosal resection using a three-channel outer tube and multiple forceps: an experimental assessment.
作者信息
Mukai M, Iwase H, Himeno S, Ishii M, Yasuda S, Nakazaki H, Makuuchi H
机构信息
Dept. of Surgery, Tokai University Oiso Hospital, Kanagawa, Japan.
出版信息
Endoscopy. 2001 Mar;33(3):253-6. doi: 10.1055/s-2001-12810.
BACKGROUND AND STUDY AIMS
Colorectal endoscopic mucosal resection (EMR) has limitations both anatomically and technically when it is done using the conventional snare wire method. The aim of this study was to develop a new method and instrument for colorectal EMR.
METHODS
A total of 21 EMR procedures were done using ten surgical specimens. Saline was injected into the normal submucosa of freshly resected colorectal specimens to prepare a pseudotumor. EMR was performed experimentally by employing a three-channel outer tube with three forceps and a colonoscope with a needle-type precutting knife. This method was assessed in terms of safety and the size of the resected specimens.
RESULTS
Perforation occurred only twice in the initial stage of this study. The size of the specimens resected by EMR was 28-39 mm (long diameter 34.8+/-3.11), by 22-28 mm (short diameter 25.8+/-2.07).
CONCLUSION
This method can achieve safety and en bloc mucosal resection to the submucosal layer. This novel approach may be promising for clinical application as a new form of endoscopic surgery.
背景与研究目的
采用传统圈套器法进行结直肠内镜黏膜切除术（EMR）时，在解剖学和技术上均存在局限性。本研究旨在开发一种用于结直肠EMR的新方法和器械。
方法
使用10个手术标本进行了总共21例EMR操作。将生理盐水注入新鲜切除的结直肠标本的正常黏膜下层以制备假瘤。通过使用带有三把钳子的三通道外管和带有针型预切开刀的结肠镜进行实验性EMR。从安全性和切除标本的大小方面对该方法进行了评估。
结果
在本研究的初始阶段仅发生了两次穿孔。EMR切除标本的大小为长径28 - 39 mm（34.8±3.11），短径22 - 28 mm（25.8±2.07）。
结论
该方法能够实现安全且完整地切除至黏膜下层的黏膜。作为一种新型内镜手术形式，这种新方法在临床应用中可能具有前景。
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